Exploratory Analysis of Nutritional Quality and Metrics of Snack Consumption among Nepali Children during the Complementary Feeding Period

© 2016 Sarah Hoibak/VectorWorks, Courtesy of Photoshare

This paper published in the journal Nutrients in December 2019 used exploratory analysis to examine how nutritional quality of snacks consumed specifically between meals relates to overall dietary adequacy and total energy intakes for young children during the complementary feeding period. In addition, the paper explores different metrics of snack consumption to understand correlations with dietary outcomes.  Data were analyzed from one-year-old children living in Kathmandu Valley, Nepal.


The World Health Organization recommends feeding snacks between meals to young
children. This study explored nutritional quality of snacks consumed between meals and
consumption metrics (% total energy intakes (%TEI) and amount of kcal from snacks) to understand
correlations with dietary outcomes (total energy intakes and dietary adequacy) and body-massindex-
for-age z-scores (BMIZ). Data used were 24-h dietary recalls and anthropometric
measurements among a representative sample (n = 679) of one-year-olds in Nepal. Nepali meal
patterns for young children were identified through formative research and all foods/beverages
consumed outside of meals were categorized as snacks. A nutrient profiling model was used to
categorize snacks as healthy or unhealthy, based on positive and negative nutrient content. Snacks
consumed between meals provided half of all energy consumed, and were associated with increased
energy and nutrient intakes. The positive effect of snacks between meals on dietary adequacy was
greater when these snacks were healthy, while increasing %TEI from unhealthy snacks consumed
between meals was negatively associated with dietary adequacy. Consumption of snacks between
meals was not associated with mean BMIZ among the children. These findings indicate that the
provision of and nutritional quality of snacks are important considerations to communicate to
caregivers. Discouragement of unhealthy, nutrient-poor snacks is critical for complementary
feeding dietary guidelines in contexts experiencing nutrition transition.


Alissa M. Pries, Elaine L. Ferguson, Nisha Sharma, Atul Upadhyay and Suzanne Filteau.

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